Human Pulmonary Vascular Responses to Hypoxia and Hypercapnia

Overview

Journal Pflugers Arch

Specialty Physiology

Date 2004 Aug 24

PMID 15322849

Citations 17

Authors

K L Dorrington

N P Talbot

Affiliations

Soon will be listed here.

Abstract

The ability of alveolar gas composition to influence pulmonary vascular tone has been appreciated for over 50 years. In particular, it has been proposed that both O2 and CO2 could play a role in the matching of perfusion to ventilation within the lung, improving the overall efficiency of gas exchange. A wide variety of experimental approaches has been used to investigate pulmonary vascular effects of the respiratory gases in a range of mammalian species. In this article, we review experiments performed in healthy humans, identify particular difficulties in the interpretation of such experiments, and discuss possible approaches to future study.

Citing Articles

Navigating Heart-Lung Interactions in Mechanical Ventilation: Pathophysiology, Diagnosis, and Advanced Management Strategies in Acute Respiratory Distress Syndrome and Beyond.

Zakynthinos G, Tsolaki V, Mantzarlis K, Xanthopoulos A, Oikonomou E, Kalogeras K J Clin Med. 2025; 13(24.

PMID: 39768712 PMC: 11728210. DOI: 10.3390/jcm13247788.

The Tissue Response to Hypoxia: How Therapeutic Carbon Dioxide Moves the Response toward Homeostasis and Away from Instability.

Rivers R, Meininger C Int J Mol Sci. 2023; 24(6).

PMID: 36982254 PMC: 10048965. DOI: 10.3390/ijms24065181.

Nocturnal hypercapnia with daytime normocapnia in patients with advanced pulmonary arterial hypertension awaiting lung transplantation.

Nakatsuka Y, Chen-Yoshikawa T, Kinoshita H, Aoyama A, Kubo H, Murase K PLoS One. 2020; 15(4):e0227775.

PMID: 32294102 PMC: 7159234. DOI: 10.1371/journal.pone.0227775.

The effects of ventilation on left-to-right shunt and regional cerebral oxygen saturation: a self-controlled trial.

Li P, Zeng J, Wei W, Lin J BMC Anesthesiol. 2019; 19(1):178.

PMID: 31597560 PMC: 6784331. DOI: 10.1186/s12871-019-0852-1.

Regional pulmonary perfusion patterns in humans are not significantly altered by inspiratory hypercapnia.

Asadi A, Sa R, Arai T, Theilmann R, Hopkins S, Buxton R J Appl Physiol (1985). 2019; 127(2):365-375.

PMID: 31169470 PMC: 6732437. DOI: 10.1152/japplphysiol.00254.2018.

References

GROVES B, Reeves J, Sutton J, Wagner P, Cymerman A, Malconian M . Operation Everest II: elevated high-altitude pulmonary resistance unresponsive to oxygen. J Appl Physiol (1985). 1987; 63(2):521-30. DOI: 10.1152/jappl.1987.63.2.521. View

Papazian L, Roch A, Bregeon F, Thirion X, Gaillat F, Saux P . Inhaled nitric oxide and vasoconstrictors in acute respiratory distress syndrome. Am J Respir Crit Care Med. 1999; 160(2):473-9. DOI: 10.1164/ajrccm.160.2.9809110. View

Neely C, Stein R, Matot I, Batra V, Cheung A . Calcium blockage in pulmonary hypertension and hypoxic vasoconstriction. New Horiz. 1996; 4(1):99-106. View

Morrell N, Nijran K, Biggs T, Seed W . Magnitude and time course of acute hypoxic pulmonary vasoconstriction in man. Respir Physiol. 1995; 100(3):271-81. DOI: 10.1016/0034-5687(95)00002-u. View

COURNAND A, RILEY R . Pulmonary circulation and alveolar ventilation perfusion relationships after pneumonectomy. J Thorac Surg. 1950; 19(1):80-116. View

Barer G, Shaw J . Pulmonary vasodilator and vasoconstrictor actions of carbon dioxide. J Physiol. 1971; 213(3):633-45. PMC: 1331746. DOI: 10.1113/jphysiol.1971.sp009405. View

Leach R, Robertson T, Twort C, Ward J . Hypoxic vasoconstriction in rat pulmonary and mesenteric arteries. Am J Physiol. 1994; 266(3 Pt 1):L223-31. DOI: 10.1152/ajplung.1994.266.3.L223. View

Lodato R, Michael J, Murray P . Multipoint pulmonary vascular pressure-cardiac output plots in conscious dogs. Am J Physiol. 1985; 249(2 Pt 2):H351-7. DOI: 10.1152/ajpheart.1985.249.2.H351. View

Kiss L, Schutte H, Mayer K, Grimm H, Padberg W, Seeger W . Synthesis of arachidonic acid-derived lipoxygenase and cytochrome P450 products in the intact human lung vasculature. Am J Respir Crit Care Med. 2000; 161(6):1917-23. DOI: 10.1164/ajrccm.161.6.9906058. View

10.

Ward J, Robertson T . The role of the endothelium in hypoxic pulmonary vasoconstriction. Exp Physiol. 1995; 80(5):793-801. DOI: 10.1113/expphysiol.1995.sp003887. View

11.

McMurtry I, Petrun M, Reeves J . Lungs from chronically hypoxic rats have decreased pressor response to acute hypoxia. Am J Physiol. 1978; 235(1):H104-9. DOI: 10.1152/ajpheart.1978.235.1.H104. View

12.

Marshall B, Marshall C, Frasch F, Hanson C . Role of hypoxic pulmonary vasoconstriction in pulmonary gas exchange and blood flow distribution. 1. Physiologic concepts. Intensive Care Med. 1994; 20(4):291-7. DOI: 10.1007/BF01708968. View

13.

Rogers S, Benumof J . Halothane and isoflurane do not decrease PaO2 during one-lung ventilation in intravenously anesthetized patients. Anesth Analg. 1985; 64(10):946-54. View

14.

Benumof J, Wahrenbrock E . Blunted hypoxic pulmonary vasoconstriction by increased lung vascular pressures. J Appl Physiol. 1975; 38(5):846-50. DOI: 10.1152/jappl.1975.38.5.846. View

15.

Blitzer M, Loh E, Roddy M, Stamler J, Creager M . Endothelium-derived nitric oxide regulates systemic and pulmonary vascular resistance during acute hypoxia in humans. J Am Coll Cardiol. 1996; 28(3):591-6. DOI: 10.1016/0735-1097(96)00218-5. View

16.

Bartsch P, Maggiorini M, Ritter M, Noti C, Vock P, Oelz O . Prevention of high-altitude pulmonary edema by nifedipine. N Engl J Med. 1991; 325(18):1284-9. DOI: 10.1056/NEJM199110313251805. View

17.

Bjertnaes L . Hypoxia-induced pulmonary vasoconstriction in man: inhibition due to diethyl ether and halothane anesthesia. Acta Anaesthesiol Scand. 1978; 22(6):570-8. DOI: 10.1111/j.1399-6576.1978.tb01340.x. View

18.

Kiely D, Cargill R, Lipworth B . Effects of hypercapnia on hemodynamic, inotropic, lusitropic, and electrophysiologic indices in humans. Chest. 1996; 109(5):1215-21. DOI: 10.1378/chest.109.5.1215. View

19.

Naeije R, Brimioulle S . Physiology in medicine: importance of hypoxic pulmonary vasoconstriction in maintaining arterial oxygenation during acute respiratory failure. Crit Care. 2001; 5(2):67-71. PMC: 137269. DOI: 10.1186/cc989. View

20.

Chen S, Chen Y, Meng Q, Durand J, DiCarlo V, Oparil S . Endothelin-receptor antagonist bosentan prevents and reverses hypoxic pulmonary hypertension in rats. J Appl Physiol (1985). 1995; 79(6):2122-31. DOI: 10.1152/jappl.1995.79.6.2122. View